Background

We had previously identified the following risk factors for insufficient control of early T-stage head and neck cancer by transoral surgery (TOS): (1) tumor thickness > 7 mm on enhanced computed tomography (CT), and (2) poor differentiation in pathological examination. We subsequently used a different patient cohort to validate the usefulness of these factors in determining the need for adaptation of TOS.

Study setting

A prospective observational study

Methods

Patients who received TOS as a definitive treatment between April 1, 2016 and September 30, 2020 were included. Primary control rates (by single TOS and TOS alone) in relation to the above-mentioned risk factors were calculated. Overall (O), recurrence-free (RF), and disease-free (DF) survival (S) outcomes were evaluated. A combination analysis based on the number of risk factors was also performed.

Results

Patients with tumor thickness > 7 mm had a 2.88-fold [95% confidence interval (CI) 1.01–8.51] higher risk of incomplete primary resection by single TOS, while patients who showed poor differentiation on pathological assessments had a 13.14-fold (95% CI 3.66–47.14) higher risk of insufficient primary control by TOS alone. The 3 year OS, RFS, and DFS rates were 99%, 83%, and 63%, respectively. Patients with both risk factors had a 93.00-fold (95% CI 4.99–1732.00) higher risk of incomplete primary control by TOS alone.

Conclusions

Among patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal squamous cell carcinoma, primary control by TOS alone may not be achieved in patients with both risk factors, that is, tumor thickness > 7 mm as measured by enhanced CT and poor differentiation on pathological examination.

中文翻译：

---

经口手术初步控制早期 T 期喉、口咽和下咽鳞状细胞癌的危险因素的验证：一项前瞻性观察研究

背景

我们之前已经确定了以下通过经口手术 (TOS) 无法充分控制早期 T 期头颈癌的风险因素：(1) 增强型计算机断层扫描 (CT) 上的肿瘤厚度 > 7 mm，以及 (2) 分化差病理检查。我们随后使用不同的患者队列来验证这些因素在确定是否需要适应 TOS 方面的有用性。

学习环境

一项前瞻性观察研究

方法

包括在 2016 年 4 月 1 日至 2020 年 9 月 30 日期间接受 TOS 作为最终治疗的患者。计算与上述风险因素相关的主要控制率（通过单一 TOS 和单独的 TOS）。评估总体 (O)、无复发 (RF) 和无病 (DF) 生存 (S) 结果。还进行了基于风险因素数量的组合分析。

结果

肿瘤厚度 > 7 mm 的患者单次 TOS 不完全原发切除的风险高 2.88 倍 [95% 置信区间 (CI) 1.01-8.51]，而病理评估显示分化差的患者的风险高 13.14 倍 (95 % CI 3.66–47.14) 单独使用 TOS 的初级控制不足的风险较高。3 年 OS、RFS 和 DFS 率分别为 99%、83% 和 63%。具有两种危险因素的患者单独使用 TOS 进行不完全初级控制的风险高 93.00 倍（95% CI 4.99–1732.00）。

结论

在早期喉癌、口咽癌和下咽鳞癌患者中，单用 TOS 可能无法对同时具有这两个危险因素的患者实现一级控制，即增强 CT 测量的肿瘤厚度 > 7 mm 和病理学分化差。考试。